Barnaby Perks, CEO of Oxford VR, explains how the exciting world of immersive technology can deliver automated mental health therapies in an engaging and effective way – to many more people than currently possible
One in four people in the world are affected by mental health disorders at some point in their lives. The effects don’t just impact the individual; they are much more far reaching. Family members, employers, economic productivity, and health and welfare systems are all affected. In fact, mental health problems represent the largest single cause of disability in the UK and the cost to the economy is estimated at £105 billion a year – roughly the cost of the entire NHS.
While there’s no shortage of high-quality, evidence-based psychological treatments for many mental health problems, what is lacking is the skilled clinicians to deliver them. So how can we up the fight against mental illness and reach out further to the people that need help the most?
Virtual Reality (VR) has opened up exciting possibilities in the world of mental health. Although VR was first developed in the mid-1960s, the essential elements haven’t changed greatly over the years – a computer generates an image, a display system presents the sensory information and a tracker feeds back the user’s position and orientation to update the image. What is new is the sophistication and affordability of the technology. VR has entered the consumer electronics world via gaming headset devices like the Oculus Rift and HTC Vive. They offer a whole new way to play, immersing the user deep in adventures and experiences inside a simulated world. But these technologies are not just for gaming, VR can now transform the way society tackles mental health problems.
In England treatment options for mental health have increased significantly since 2008 via the Improving Access to Psychological Therapies scheme, which aims to expand access to services and train 10,500 therapists by 2021. Yet providing timely treatment to everyone who needs it will remain challenging: demand for treatment far outstrips supply.
Talking therapies such as Cognitive Behaviour Therapy (CBT) are generally effective for problems such as anxiety and depression. Such therapies focus on changing the way the individual thinks and behaves. However, the most powerful change happens when people are directly presented with the situations that cause them distress and learn in that moment how to think, feel and behave more constructively. This means taking cognitive treatments out of the consulting room and into the real world, with the therapist acting more like a personal trainer or coach. Unfortunately, however, this rarely occurs. Even when therapists recognise the value of this approach, time is at a premium.
Automated VR treatments use a virtual coach or life-like avatar to enable quick, cost-effective and high-quality access to therapy services. The virtual coach guides the user through the therapy session, asking questions about thoughts and feelings, and providing instruction, advice, and encouragement. This helps overcome the shortage of real-life therapists to improve access to therapy whilst also providing a talking, emotive guide that consistently presents the therapeutic intervention in an engaging, but standardised way thereby ensuring adherence to protocol.
In VR we can create powerful simulations of the scenarios in which psychological difficulties occur. For example, it would negate the need for a therapist to accompany a socially anxious patient to a real-life crowded shopping centre. Furthermore, situations that are almost impossible to build in to a course of therapy – for instance, the kind of traumatic event that can cause PTSD – can be recreated digitally and experienced by the patient in a carefully controlled way as often as necessary.
VR has another advantage. Because the situations are not real, patients have the confidence to try things they would normally avoid. For example, someone with social anxiety worried about entering a busy café can practise – as many times as they like – more positive ways of thinking and behaving in a VR scenario. A person with a fear of heights who would never dream of venturing to the top floor of a shopping centre will try it out in a virtual environment. Yet although it is a computer-generated environment, the mind and body behave as if it were real. This means that the lessons learned in VR transfer into everyday life.
Digital health innovations, like any other treatment modality, need to be underpinned by scientific evidence showing the clinical, operational and long-term financial benefits to patients and health systems. Built on nearly two decades of research at Oxford University, the team at Oxford VR is well positioned to produce evidence-based therapies that can transform treatment access and operating economics for the world’s most common, costly and debilitating disorders.
Led by Chief Clinical Officer, Daniel Freeman, Professor of Clinical Psychology and NIHR Research Professor at the University of Oxford, the team recently completed the first review of every study that has used VR to assess, understand and treat mental health conditions. In over 25 years, and 285 studies across the range of anxiety disorders, the results unequivocally confirm that VR is a proven modality for delivering rapid, lasting improvement for patients.
At present, treatments for phobias, anxiety, psychosis, depression and addiction are underway. Each treatment is carefully designed to tackle a specific clinical condition. There is no ‘one size fits all’ approach to mental health disorders. Instead, treatments are based on proven therapeutic protocols. It is this clinical expertise informed by decades of research and clinical practice that informs the development of roleplay situations inside the immersive environment.
With an ever-growing base of healthcare collaborators and technology partners from around the world, we are committed to leading the vanguard of VR treatments. These will offer not only a powerful and scalable complement to existing treatment options, but also help provide faster access to high-quality therapy for the one in four people who so urgently need it. This really is an exciting and inspiring time for mental health innovation.
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